Head and Neck Pathology

, Volume 7, Supplement 1, pp 59–67 | Cite as

Low-Grade Salivary Duct Carcinoma or Low-Grade Intraductal Carcinoma? Review of the Literature

Invited Review: An Update on Salivary Gland Pathology

Abstract

Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with “Roman Bridges”, “pseudocribriform” proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in non-invasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/high-grade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are non-invasive neoplasms; the terms “cribriform cystadenocarcinoma” and LG-SDC should be replaced by “low-grade intraductal carcinoma” (LG-IDC) of salivary gland or “low-grade intraductal carcinoma with areas of invasive carcinoma” in those cases with evidence of invasive carcinoma.

Keywords

Low-grade salivary duct carcinoma Low-grade intraductal carcinoma Cribriform cystadenocarcinoma Salivary duct carcinoma Parotid gland Salivary glands 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ying-Ju Kuo
    • 1
  • Ilan Weinreb
    • 2
    • 3
  • Bayardo Perez-Ordonez
    • 2
    • 3
  1. 1.Department of Pathology and Laboratory MedicineTaipei Veterans GeneralTaipeiTaiwan
  2. 2.Department of Pathology, Toronto General HospitalUniversity Health NetworkTorontoCanada
  3. 3.Department of Laboratory Medicine and PathobiologyUniversity of TorontoTorontoCanada

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